Provider Demographics
NPI:1578894168
Name:CRAWFORD, RICHARD DEE (LPC,LMFT,NCC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DEE
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:LPC,LMFT,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-7949
Mailing Address - Country:US
Mailing Address - Phone:918-787-2104
Mailing Address - Fax:918-787-2106
Practice Address - Street 1:905 E 3RD ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-7949
Practice Address - Country:US
Practice Address - Phone:918-787-2104
Practice Address - Fax:918-787-2106
Is Sole Proprietor?:No
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK451101YP2500X
OK596106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731013488Medicaid